Provider Demographics
NPI:1326481136
Name:NGUYEN, MYLINH (PHARM D)
Entity Type:Individual
Prefix:
First Name:MYLINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SW 122ND ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-2847
Mailing Address - Country:US
Mailing Address - Phone:206-356-9523
Mailing Address - Fax:
Practice Address - Street 1:21615 PACIFIC HIGHWAY SO.
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198
Practice Address - Country:US
Practice Address - Phone:206-878-4627
Practice Address - Fax:206-878-1945
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR 60088534390200000X
WAPH60368015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program